Dr say no more herceptin forever

[jas]

I am writing on behalf of my mother who was diagnosed with stage 3A Grade 3 Her2 breast cancer in September 2005 she is 59 years old. She has recieved cemo and has completed 9 doses of 3 weekly herceptin. She has recently had a heart scan MUGA at she had a reading of 49 this has come down from 65 when she was tested before all treatment. She went to see her ONC who said her was going to stop her taking herceptin permanently. No break and then go back on - he wants to stop it forever. He said that the risk in terms of damage to her heart was not worth taking. He said that the Finnish study showing that taking herceptin for a short period of time was just as beneficial as taking it for a year.

My mother really likes and respects her doctor and he is from St Barthomews hospital in London, it has a very good reputation.

I am worried that not giving her the option of re starting Herceptin after a break is a mistake. He did say to her that in 6 weeks he is sure that her heart function will return to normal.

Is this good advice? Im worried the decision may have something to do with financial pressures regarding the expence of Herceptin.

[John21]

I would get a second or third opinion on that!



John

[karenann]

I would also get a second opinion. My ef dropped from 62% down to 51% after my 10th herceptin. We waited six weeks and did another echo, which showed that my ef had gone back up to 61%. I went back on herceptin and just completed my year 7 weeks ago.

Karen

[Christine MH-UK]

The FinHer protocol used herceptin-based chemotherapy: 3*(herceptin+taxotere) -> 3 * FEC60, which turned out to have a disease free recurrence rate similar to the trials using long periods of herceptin after herceptin-based chemo. It is important to keep the following things in mind:

1) This trial used herceptin-based chemo, not herceptin following chemo. It is known that herceptin strengthens the effectiveness of taxotere, so this might be an important difference.

2) My oncologist feels that FinHer seems promising, but that it needs further followup. FinHer was only about a fifth the size of the big herceptin trials and, as a result, it is not entirely clear that nine weeks of herceptin-based chemo is really as good as a year of herceptin.

The unfortunate truth of the matter is that noone knows the minimum amount of time that patients need to get herceptin to get the benefits.